1.

Safety: Orientation and Mobility (O&M) skills allow you to explore and interact with the
world safely, including your home, school, and community  1.
2. Independence: O&M skills help you move around independently without relying on
others 1.
3. Confidence: O&M skills help you build confidence in your ability to navigate the world
around you 1.
4. Socialization: O&M skills help you participate in social activities by giving you the ability
to travel to different places 1.
5. Cognitive Development: Movement teaches the brain. O&M teaches movement with a
purpose. Movement with purpose may not occur naturally for children who have a visual
problem. Early evaluation of O&M is very important  31.

Sighted Guides

Sighted guide technique is considered to be the most efficient and commonly used technique for the
mobility of the person with visual impairment.

In this technique, the person with visual impairment is accompanied by a sighted companion who guides
him about the path and direction, giving the person specific instructions during walking.

The visually impaired and the sighted person are both given training. The sighted person is trained
regarding how to guide in different circumstances, such as going up and coming down the stairway,
through narrow paths and doorways and how to avoid or cross obstacles.

The person with visual impairment is given training to receive and understand information from the
guide. In fact, the parent and family members can, and should, learn to use the sighted-guide technique
correctly, along with the child.

With practice, communication begins to get established between the guide and the person with visual
impairment. The guide does not then have to verbally give instructions each time. The pressure of the
guide's hands, his pace of walking, etc. communicate to the visually impaired person regarding the
change in direction, obstacles in the way and so on.

Basic Steps of Sighted Guide Technique

The following are the steps of the basic sighted guide technique.

Step 1 : Stand next to the person with visual impairment and face in the same direction as he is facing.
Step 2 : Let the person know where you are standing by touching the back of his hand.

Step 3 : Train the person to move his hand up your arm to find your elbow.
Step 4 : Ask the person to hold your arm slightly above the elbow with a firm, but relaxed grip in such a
position that his thumb is on the outside of your elbow.

Step 5 : The person should hold your elbow close to the body and should always be half a step behind
you with his shoulders directly in line, and behind.

Step 6 : The person can be either on your left or right side, depending on which side both of you feel
more' comfortable.

Step 7: Begin using the sighted guide technique by first moving around with the person in the house. As
you and the person move around, describe to him the various rooms, the way the furniture kept in the
room, the things to avoid and so on. This descrigtion helps the person to form a mental map of all rooms
and is a part of orientation training.

Step 8 : Once the persdn is able to move around in the house, take him outside in the neighbourhood,
fqr instance, the park. Guide him to the trees, flowers, swings fence and so on and encourage him to
touch things.

Approaching Narrow paths

Basic sighted guide technique has to be modified when approaching narrow spaces, doors and staircases
as well as how you may help the person sit on a chair. Techniques to be Used in Narrow Spaces While
approaching narrow spaces you should

Step 1 : Move your guiding elbow towards the midline of your back.

Step 2 : Extend your arm and move sideways in the narrow space so that the person with visual
impairment is directly behind you. This gesture of yours will immediately communicate to the person
with visual impairment that there is a narrow space ahead and even he might have to squeeze his body
a little bit when moving through the narrow space. After the narrow space is over, both of you should
return to the normal position of the sighted-guide technique.

Techniques to be Used at Staircase When you approach the staircase, you have to

Step 1 : Inform the visually impaired person about the change in movement which is about to occur due
to the stairs.

Step 2 : Stop right in front of the stairs so that the person is half a step behind you. Ask the person to
feel and judge the height of the steps with his foot.

Step 3 : Begin climbing the steps in the normal way, with the person following a step behind.

Step 4 : Both of you should shift your weight forward by leaning forward slightly, so as to avoid a fall.
Step 5 : If there is a railing, ask the person to keep his free hand on the railing as a support and climb the
stairs (refer to illustration on the next page).
Similarly, while descending, the same procedure should be followed. However, both the guide and the
visually impaired person should shift their weight backwards by leaning back a bit.

Techniques to be Used to Approach a Doorway

When approaching a doorway, you should

Step 1 : Tell the person which way the door opens. Open the door with. your free hand,(i.e., the arm
which the visually impaired person is not holding). Subsequently, hold the handle of the door with your
guiding arm.

Step 2: Now transfer the handle to the person who in turn pulls it to open the door farther, and you
proceed through it first. Step 3 : Once you move out, take hold of the handle on the opposite side of the
door to enable the person to pass through. . Step 4 : Pull the door close behind him and start walking.

Techniques to be Used to Approach a Doorway

When approaching a doorway, you should

Step 1 : Tell the person which way the door opens. Open the door with.Your free hand,(i.e., the arm
which the visually impaired person is not holding). Subsequently, hold the handle of the door withyour
guiding arm.

Step 2: Now transfer the handle to the person who in turn pulls it to open the door farther, and you
proceed through it first.

Step 3 : Once you move out, take hold of the handle on the opposite side of the door to enable the
person to pass through. .

Step 4 : Pull Precautions that the sighted guide should observe The following are some of the
precautions to be taken when acting as a

Tips on sighted guide.

1) You have to remember that the person is following you and is behind you. Therefore, do not walk too
fast or too slow.

2) You must never push or pull the person from the back.

3) Approach the door/steps straight on and not from the side. In case you approach these from the side,
the person will receive the wrong direction.

4) You must inform the person in advance if there are pits, dug up holes or any other thing which needs
to be crossed with a low jump.

5) Remember that, the person should always be behind you.

7) While going up or down the stairs, the visually impaired person should be on the side on which there
is a railing. e door close behind him and start walking.

8) An inexperienced sighted person should act as a guide only after knowing what to do.

9) Use your normal tone of speech while giving instructions.

10) Always describe the surroundings to the person - whether moving inside or outside the house. This
will help the person to develop a mental lineage of the surroundings and will help him to move around
independently later, using the stick or the cane. Further, as far as possible, take the person near objects,
such as a pole, table, wall, chair and cot, so that he can touch thein to learn about them.

Walking Alone techniques

Trailing:

The purpose of trailing is to assist with straight-line travel by maintaining a constant contact with a
surface such as a wall. Ideally, it should only be used over short distances for locating a particular
objective, such as a doorway. Travelers who lack the skills or confidence to maintain straight-line travel
when using a mobility aid such as a long cane may use trailing more often and over longer distances
than those who are competent in moving through space.

In busy or crowded areas, travelers need to be careful when trailing as they may make unexpected and
frequent contact with other pedestrians in the environment.

Facing the direction, he or she wishes to move in, the traveler extends the arm closest to the wall until
the hand is approximately at waist height. The hand is turned so that the back of the ring and little
fingers gently rest on the wall. It is important to keep fingers slightly flexed and relaxed to absorb any
contact made with objects along the wall.

The traveler maintains a light contact with the wall whilst walking parallel to it. It is important that the
arm is kept in front of the body, and not allowed to drop to the side, as this does not allow sufficient
reaction time when an obstacle is met. Travelers also need to be aware of the possibility of jamming
fingers or of doors opening unexpectedly.

Trailing is a technique that allows a person to keep oriented by staying in contact with a wall or other
surface in the environment. It can be useful in situations such as walking in a straight line down a
hallway or navigating around the counter in the kitchen. Trailing also provides some protection from
random objects.
To use the trailing technique, stand approximately 6 inches from a wall.

Extend the arm closest to the wall about a foot in front of your body at the hip level.

Hold your hand with the palm toward the floor, and then cup your fingers in a loose fist toward the palm
to protect your fingers from any object they might encounter.

Place the side of this hand against the wall and allow it to move along the wall lightly as you walk
forward.

Orient yourself by visualizing any landmarks that may be encountered along the wall.

Perhaps there is a closet door or protruding object that your hand may come across along the way.
Landmarks such as a closet door can be helpful with navigating.

For example, if there are two similar hallways, but only one has a closet, it provides an easy way to
differentiate.

When you come to an open doorway, maintain your direction, and keep going. With a couple of steps,
you will reach the other side, and you can continue trailing the wall.

For safety purposes when trailing, it's recommended that you use the upper protective technique with
your other arm to prevent accidental collisions as you explore various parts of your home.

Direction Taking/Parallel Alignment:

Getting a straight parallel line or course from a fixed object or a sound to better facilitate traveling in a
straight line (toward a desired objective).

Directionality

The ability to differentiate between another person’s left and right, and to judge the position of objects
in the environment relative to one’s own body

Since Orientation is a person's understanding of where they are in space and how to find their
way to a destination. Orientation includes understanding directionality (north, south, east, west)
and being aware of the features of an environment. Mobility is how people move through
environments safely and efficiently.

Directionality and spatial orientation includes:  up/down, back/front,

Squaring Off

The purpose of squaring-off is to establish a straight line of travel when crossing an open area of space.
This technique can be beneficial when going from one location to another across a large, open space.
Squaring off involves aligning or positioning your body in relation to a specific object or location in a
room and then walking in a straight line toward the item or location.

For example, this technique can be used when the refrigerator is more than three steps across the
kitchen from the stove. Place your back against the refrigerator door and walk straight across the
opening toward the stove, visualizing it in front of you.

As you approach the stove, use the lower protective technique to protect your body from crashing into
the stove. Try this technique in other rooms of your home as well as the kitchen. This method will need
to be adjusted depending on the landmark being used to square off.

At times it may be necessary to align the side of your body or the back of your legs with an object before
walking across the open space. This technique is helpful when learning a new environment or adjusting
to a decrease in vision. Keep in mind that it's essential to use your other senses and concepts such as
echolocation, which were discussed in previous lessons, to help with orientation.

Eventually, with practice, as confidence develops, walking diagonally from one place to another across
an open space without this technique may be comfortable.

Room Familiarization

The room familiarization technique can be used for new environments or places where a person is not
used to navigating independently with vision loss. It is not uncommon to use this technique in the home
after a decrease in vision.

First, stand in the doorway and visualize the room if it is familiar or have someone describe the layout if
it is a new environment. As items in the room are described or recalled, point to them with one hand
while remaining in the doorway.

Once a clear map of the space can be visualized, trail around the perimeter of the room. For people who
use a long cane, it's recommended that they hold it in one hand diagonally across their body while using
the trailing technique with the other. The room features, such as furniture arranged against the wall, a
closet, or a window, may serve as landmarks to aid your orientation.

When a piece of furniture is located while trailing, stop and carefully examine it using tactile skills. Use
search techniques and the grid pattern described in the previous lesson to determine if items are
arranged on top of furniture surfaces.

Continue around the room until everything along the perimeter of the room has been identified. Next,
move to the center of the room and explore everything there.

If a room has furnishings in the center of the room, such as a dining room or family room, use the
squaring off technique along with the cane or lower protective technique until you locate the furniture.

Techniques to be Used to Sit in a Chair

Step 1 : Bring the person to the chair, place his hand on the back of the chair and ask him to find out
which way the chair is facing.

Step 2 : Train the person to move his free hand to follow the back of the chair down to the seat, so as to
see if the chair is empty.

Step 3 : Train him to move unaided to the front of the chair, while holding the back of the chair.

Step 4 : Teach him to turn around, so that his legs are touching the front edge of the chair and then sit
down

Safety Tips

Several basic home modifications and habits can be developed to make a visually impaired person safer
in their home environment.

Non-slip rugs can be used in various ways around the home to help with orientation. They can serve as a
tactile marker since they will contrast with the flooring's texture, but if high contrast colors are used,
they may also serve as a visual cue to highlight an area.

Rugs can be placed under groupings of furniture to give a tactile cue when walking through the room.

Some individuals will also use small rugs in front of doorways, sinks, and other commonly used areas of
the home.

When using rugs for orientation, the most important thing is to make sure they will not become a
tripping hazard. All rugs should be non-slip and be tacked down on the edges. It may not be
recommended to use this method for people with mobility aids such as walkers.

Stairs, hallways, and frequently traveled pathways should be kept clear and free of all clutter. Many
people have a habit of leaving something on the stairs that they plan to take up or down with them the
next time they go. These can be dangerous habits.

Safety needs to come first, so take the time to identify any walkways which are cluttered. Methods for
organization will be covered in a later lesson, so the first step is to get items off the floor.

Lighting, contrasting colors, and textures can also be used around the home in various ways to create a
safer environment. For people with some remaining vision, sufficient lighting should be used above
stairways and other areas, presenting a safety hazard. High contrast colors and various textures can also
be used in strategic areas. For example, non-slip tape in a contrasting color can be placed on the edge of
steps to make them more visible. There is a type of tape, which feels a lot like sandpaper, which can be
used outdoors for porches or decks.

Discussing safety concerns with people in the household and describing challenges related to vision loss
can be beneficial. Most family members will be more aware and conscientious if they understand what
changes need to be made. It can help to have family members participate in training lessons or do a
blindfold experience to gain more insight. However, in households where people often forget to close
cabinets, dishwasher doors, or push in their chairs at the table, methods may need to be utilized to
maintain safety.

The protective techniques learned earlier in this lesson are helpful, but people will rarely use them every
time they walk through their homes once they are comfortable. Some devices can be put on cabinet
doors, which will alert if a door has been left open for more than the programmed time.

Magnetic door stops can be used on interior doors that do not stay open entirely independently. This
will make it easier to keep doors fully open or closed and prevent someone from walking into a partially
open door. As an added safety measure, individuals can use their long cane in the home if they know
that things are often left out or relocated. This is a common precaution when small children in the house
leave toys on the floor

One basic concept is that sharp objects such as knives and scissors should never be left where the blades
or points can come into accidental contact with any part of your body. For example, sharp knives should
be placed behind the cutting board, not on it, when slicing vegetables, or placed behind the kitchen

The Guide Dog Technique

Using trained guide dogs for mobility is popular in some countries. The technique has not been adopted
in our country due to the following reasons: - Lack of training facilities for training the guide dogs. - Very
high cost of maintaining such dogs. - Crowded places and lack of traffic regulations. - Risk to the guide
dog from stray dogs and other wild animals. - Religious considerations of not allowing dogs into the
house, especially kitchen and bedroom. - Guide dog techniques generally cannot be used to the
exclusion of dther techniques

Basic Steps in using Guide Dog

Step 1: Usually, the dog is controlled by the left hand and the right hand is used for holding the cane.
Step 2: The dog is trained to follow commands which are generally given by raising its harness.

Step 3 : The person with visual impairment has to be trained to understand the cues provided by the
dog. For example, the dog would stop at an entrance and would deliberately go around an obstacle.
Generally, the dog proceeds (moves ahead of) the person. However, while boarding the bus, the dog
should follow and while climbing down the stairs, the dog should walk along with the person.
Step 4 : The person must have complete control of the dog. The dog cannot perform all functions for
handling road traffic.

Long cane

The use of the cane helps in locating obstacles along the route and provides information about the
environment. The cane stick is inexpensive and handy.

The cane has the additional advantage of being adjustable to the height of the person.

The use of the cane stick enables the person to move independently as well as safely, and greatly
enhances opportunities for integration into the community, for education and employment. The
techniques of using the white cane are simple and easy to learn and, hence, Orientation and I it can be
used ease in an unknown environment too.

Persons with varying physical capabilities can be trained to use the cane, as the cane can be modified to
suit individual needs.

There are various types of white canes available in the market. You can choose among them, depending
on the person's specific needs and affordability. The length of the cane is determined by the height of
the user - for adults it is generally 90 cms.

As a general rule, the cane should reach up to the breast bone (i.e., it should reach halfway between
the shoulder and the waist) when held vertically on the ground. If the person walks quickly or takes big 1
steps, the cane can be a little longer.

The various types of canes are:

I a) Lang cane: It is made up of aluminum tubing of 12mm outer diameter ,and is 90 cm long. It has a
grip at the top and a nylon tip at the bottom, so that it does not slip. Long cane is used by adults.

b) Folding cane: This is the same as the long cane, but it can be folded and kept in the bag while
travelling in a public transport.

c) Laser cane: This cane has a device that emits infrared beams in three directions - up, down and
sideways. These beams strike an object and bounce back and provide a sound. The sound tells the
person about the direction and the distance of the object.

Of course, the person has to be trained to distinguish that different pitches of the sound indicate
differences in distance.

In place of the white cane, you can also use the bamboo stick or a cane made from a tree branch, To
devise a cane yourself, first find a stick that the person can use. You can cut the stick from the branch of
a tree or a I bamboo.

The stick should be straight and not too heavy.

Qualities of a Good Cane

A good cane should possess the following qualities:.

I. Good conductivity

ii) Durability

iii) Light weight

iv) Low cost

v) Elegant appearance

vi) ' Easy availability

vii) Easy reparability

viii) Meeting the specific length requirements

The specialized knowledge of the long cane and its techniques is unique to the profession of O&M.
With appropriate O&M instruction, the long cane can provide individuals with visual impairments
with information about objects, surface changes, and surface integrity in the immediate environment
(Blasch, LaGrow, & De l’Aune, 1996). The long cane also serves as a means of identification of its user
as a person with a visual impairment. Long canes come in a variety of materials, lengths, and colors,
and they have different features (e.g., folding, telescoping) and types of tips. O&M specialists prescribe
or recommend an appropriate long cane for individuals while accounting for factors such as height, gait,
walking speed, proprioceptive and tactile sensitivity, travel environments, and personal preferences.
O&M specialists may also recommend adaptive mobility devices for the specific needs of very young
children or individuals with additional disabilities, as an alternative to the long cane or to facilitate
transition to a long cane. O&M specialists teach techniques for using the long cane in a multitude of
travel situations and environments. The methods used to maneuver the long cane in a specific situation
depend on factors such as the type of ground surface being traversed, the individual’s functional vision
and need to locate landmarks, and the presence of stairs, obstacles, or narrow openings in the travel
path. Long cane techniques include diagonal, two-point touch, constant contact, touch and drag, touch
and slide, and three-point touch technique (Fazzi & Barlow, 2017; Jacobson, 2013). Long cane
instruction also includes techniques for traversing congested areas, and navigating doors, curbs, stairs,
elevators, and escalators. O&M specialists teach individuals with low vision how to maximize use of
functional vision while using the long cane. Instruction may also include O&M Scope of Practice 12
adapted cane techniques for people who use other mobility devices (e.g., support canes, walkers, and
wheelchairs). Through careful monitoring of individual progress, O&M specialists structure lessons in a
manner that promotes overlearning of cane techniques and facilitates skill generalization across
environments and situations.